Resistance to fracture of roots filled with different sealers

Abstract

INTRODUCTIONRoot-fi lled teeth are more susceptible to fracture than vital teeth. Ironically, these teeth which were already compromised before root canal treatment are further weakened by the process. A few reasons contribute to the vulnerability of root-fi lled teeth, chief of which is root dentin dehydration after the endodontic procedures 1) . Other reasons that predispose root-fi lled teeth to fracture include brittleness of root-fi lled teeth because of loss of tooth structure 2,3) , excessive pressure during fi lling procedures 1,4) , and excessive widening of root canals 5) . After root canal treatment, the standard fi lling material is gutta percha. To obtain a hermetic seal, gutta percha is typically used in conjunction with root canal sealers because gutta percha is incapable of bonding to root canal walls. Root canal sealers not only fi ll the voids between gutta percha points, they also fi ll the voids between gutta percha and root canal walls 6) . Bondable root canal sealers purportedly improve the seal and fracture resistance of endodontically treated roots 7,8) . To date, confl icting results were reported from different research studies. On the one hand, one study 9) found no signifi cant differences in fracture resistance between roots fi lled with a bondable root canal fi lling system, Epiphany, and those fi lled with gutta percha and an epoxy resin-based sealer, AH 26. On the other hand, a study 10) found that the fracture resistance of roots fi lled with gutta percha and AH 26 was superior to that of roots fi lled with the Epiphany system.Recently, a new root canal sealer, iRoot SP (Innovative BioCreamix Inc, Vancouver, Canada), was introduced to the market. According to the manufacturer, iRoot SP is a convenient, pre-mixed, ready-to-use injectable white hydraulic cement paste developed for permanent root canal fi lling and sealing applications. Based on a calcium silicate composition, iRoot SP is an insoluble, radiopaque, and aluminum-free material which requires the presence of water to set and harden.Another recently introduced root canal sealer is MTA Fillapex (Angelus Solucxoes Odontologicas, Londrina, Brazil). Based on an MTA (mineral trioxide aggregate) composition, other ingredients of MTA Fillapex include resins and silica (Table 1). According to the manufacturer, it has high radiopacity, low solubility in contact with tissue fl uids, low expansion during setting, and excellent viscosity for insertion. It does not stain the tooth and promotes deposition of hard tissue at the root apex and perforation sites.The purpose of the study was to compare the fracture resistance of roots fi lled with gutta percha and sealed with one of these three root canal sealers: an epoxy-based root canal sealer AH Plus (Dentsply DeTrey, Konstanz, Germany), a calcium silicate-based root canal sealer iRoot SP, and an MTA-based root canal sealer MTA Fillapex. The null hypothesis was that root canal sealers would not infl uence the fracture resistance of root-fi lled teeth. MATERIALS AND METHODS Root canal p...

Fracture resistance of roots obturated with a novel calcium silicate-based endodontic sealer (BioRoot RCS)

“…[33] It has been reported that iRoot SP, MTA Fillapex, and AH Plus showed fracture resistance significantly superior to that of the negative control group, and there were no differences in fracture strength between these sealers. [13] On the other hand, previous studies performed by Tanalp et al [34] and Mandava et al [35] concluded that MTA Fillapex did not strengthen endodontically prepared teeth significantly. The results of the current study are consistent with their findings as MTA Fillapex did not reinforce the endodontically treated teeth significantly when compared with the positive control group.…”

“…[30] Thus, increased mechanical interlocking may improve resistance to fracture. [13] In addition, the extremely fine particle size and optimal premixed consistency might promote its penetration to the full length of the canal. [11] Furthermore, zirconium oxide, one of the components of the iRoot SP sealer, might play a role in increasing fracture toughness and tensile strength and in lowering Young's modulus.…”

“…iRoot SP has a composition similar to that of white mineral trioxide aggregate composed of calcium silicate, calcium phosphate, calcium hydroxide, and zirconium oxide, and has superior physical, antibacterial, and biocompatibility properties. [9][10][11][12][13][14] Another new tricalcium silicate-based sealer (MTA Fillapex; Angelus, Londrina, Brazil) composed of radiopaque bismuth, nanoparticulated silica, MTA, and pigments has been introduced recently as an endodontic filling material. According to the manufacturer, MTA Fillapex has excellent radiopacity, easy handling, excellent working time, and low solubility, enhancing sealing through expansion during setting.…”

A Comparative Study on Root Canal Repair Materials: A Cytocompatibility Assessment in L929 and MG63 Cells

“…A number of fibroblast cell lines, including L929 and 3T3, have been widely used for MTT assays due to their availability and reproducible outcomes [8–10]. Since there is direct contact between root canal repair materials and periapical tissues, these materials are expected to exhibit osteoinductive or osteoconductive properties that promote bone deposition and eventually root canal repair [4, 11]. Thus, it is also important to assess the cytocompatibility of root canal repair materials on osteoblast-like cells [12].…”

Comparative evaluation of Fracture Resistance of Endodontically Treated Teeth Obturated with Pozzolan-based MTA Sealer and Epoxy Resin-based Sealer: An in vitro Study

“…This is because of greater adhesion of AH Plus to root dentin than Endoseal MTA. Sagsen et al 11 showed that AH Plus sealer increased the fracture resistance of instrumented root canals. AH Plus has already been proven to have better penetration into the microirregularities because of its creep capacity and long polymerization period.…”